Individual
DR. BENJAMIN PEASE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15111 TWELVE OAKS CENTER DR, MINNETONKA, MN 55305-5201
(952) 993-4500
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36672
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634865300
—
MN
Enumeration date
11/29/2005
Last updated
03/06/2012
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